Dealing with snake bites

By Dr Zulfikar Bux
Guyana being in the tropics is well known for the various species of snakes that inhabit it. Snakes like every

Dr Zulfikar Bux

other animal have to survive. They will eat to live and will defend themselves once they feel threatened.
They are not as devious as sometimes portrayed and we should respect them and their habitats. When snakes do bite humans, we most likely would have invaded their territory and they were feeling threatened. There are over 200 snake bites annually in Guyana, and each has the potential of becoming complicated if not managed properly.
Snake venom acts differently according to the species of snake and the outcome has to do with the size of the snake, the amount of bites, and how agitated the snake was at the time of the bite.
Today we will discuss aspect of snake bites that we think are important for you to be aware of.HEMOTOXIC SNAKE BITES
Most venomous snakes in Guyana cause death via this means. Hemotoxic means that the venom from the snake prevents our blood from clotting. Patients that are bitten by a hemotoxic snake are at risk of bleeding to death. They have the potential to bleed from anywhere in their body and may have undetected internal bleeding. Snakes that are hemotoxic include the infamous Labaria, the rattlesnake, and the bushmaster.NEUROTOXIC SNAKE BITES
The venom from these snakes acts on our nervous system causing a paralyzing effect. We slowly start to feel numb and lose function in our body. The venom can paralyze our heart and breathing, causing death. The coral snake is the main species of neurotoxic snakes found in Guyana. The venom of the rattlesnake can also have a varying neurotoxic effect.INFECTIVE SNAKE BITES
Almost all venomous snake bites in Guyana have the potential to cause infection. Infection occurs from the bacteria and enzymes present in the snake venom. These can break down our tissues and can lead to serious infections which can cause loss of limbs or even loss of life from sepsis.WHAT TO DO IF YOU ARE BITTEN
– Remain calm: The more you panic, the faster your heart will beat and circulate the venom around your body. The calmer you are, the lesser the chance of this happening, the better the chance of you surviving
– Get to the nearest Hospital: The longer you wait to get treatment, the more you are putting yourself at risk of complications, including death.
– Lessen your physical activity: The more you do the more you will increase your heart rate and increase the venom circulation. Get others to work for you, including lifting you if possible.
– Keep your limb down: If you were bitten on a limb, then keep the affected limb down to decrease the amount of blood flowing upwards. This will decrease the rate of flow of the venom to the rest of your body.
– Let the wound bleed for shallow bites: This may help to get some venom out of your body.
– Compress squirting wounds: In cases where the bite causes blood to squirt from the wound, you should compress the wound and wrap a tight band around it.
– Clean with soap and water around the wound: Do not excessively wash the wound as this can cause other complications by itself.WHAT YOU SHOULDN’T DO
– Do not tie off/tourniquet the affected limb. This will prevent blood from reaching the limb and can worsen the situation.
– Do not try to suck the poison out. This will only compound the infection and can put the person sucking the venom out at risk of becoming sick from ingesting it.
– Do not ice the wound. This can decrease circulation leading to more tissue death and infection
– Do not use your own anti-venom. Anti-venom varies according to each species and can be dangerous to you, especially if it’s the wrong species of snake. Let your doctor decide on choice of anti-venom.
– Do not explore the wound for snake fangs. This increases the risk of venom spread and infection.
Snakes like Human beings will do what’s necessary to survive. We should avoid interfering with them if we can, and avoid areas where they may be prevalent. If you are bitten, you should remain calm and get to the nearest health facility.

(Dr Zulfikar Bux is an Assistant Professor of Emergency Medicine at the Vanderbilt University and Medical Center and holds the position of Head of the Georgetown Public Hospital’s Accident and Emergency Department.)